THE EFFECTS OF HYPOPHYSECTOMY 



ever, found that the complete removal of the gland was fol- 

 lowed by death usually within 24 hours; this result he be- 

 lieved not to be due to operative trauma either of the hypo- 

 thalamus or of other structures. Gushing and his collabora- 

 tors, Biedl, Blair Bell, and others were more or less in agree- 

 ment with this view. For example, Crowe, Cushing, and Ro- 

 mans (1910) reported that complete hypophysectomy in 

 adult dogs was followed by death within 5 days, whereas the 

 performance of the same operation in puppies permitted sur- 

 vival for as long a period as 3 weeks. They, like others, de- 

 scribed symptoms of hypophysial deficiency now recognized 

 as characteristic; however, these were frequently complicated 

 by symptoms now believed to be due chiefly to lesions of the 

 hypothalamus and/or increased intracranial pressure. Asch- 

 ner (1912), Ascoli and Legnani (1912), and Sweet and Allen 

 (1913) all believed that the removal of the pituitary body 

 was not followed by death within a short time. As a result 

 of his elaborate investigation, Aschner concluded that injury 

 of the tuber cinereum was the unrecognized complication re- 

 sponsible for the rapidly fatal issue of the operation as de- 

 scribed by Paulesco and later investigators. With few excep- 

 tions (Blair Bell, 1917; Dott, 1923), all later work (such as by 

 Benedict and Romans, 1912; Roussay and his collaborators, 

 after 1921; Camus and Roussy, 1913, 1922; Brown, 1923; 

 Dandy and Reichert, 1925; McLean, 1928; Koster and Gee- 

 sink, 1929; Karlik and Robinson, 1931) indicates that hypo- 

 physectomized dogs may live for months, but that obesity 

 and transient polyuria with or without glycosuria also fre- 

 quently occur in operated animals. 



In order to gain access to the gland, two types of approach 

 are commonly used: the temporal and the buccal. The tem- 

 poral approach is aseptic but is more likely to be complicated 

 by direct or indirect injury of the brain. The disadvantage 

 and advantage of the buccal approach are the reverse of those 

 of the temporal approach: asepsis cannot be complete; serious 



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